Provider Demographics
NPI:1801091871
Name:LAMB, ALAN THOMAS (LCSW)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:THOMAS
Last Name:LAMB
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 FREEDOM BLVD
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-2780
Mailing Address - Country:US
Mailing Address - Phone:831-763-8200
Mailing Address - Fax:831-454-4663
Practice Address - Street 1:1430 FREEDOM BLVD
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-2780
Practice Address - Country:US
Practice Address - Phone:831-763-8200
Practice Address - Fax:831-454-4663
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 133691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS13369OtherPROFESSIONAL LICENSE#
CAZZZ91891ZOtherMEDICARE GROUP PTAN#
CAZZZ92069ZOtherMEDICARE GROUP PTAN#
CAZZZ91892ZOtherMEDICARE GROUP PTAN#
CAZZZ91892ZOtherMEDICARE GROUP PTAN#
CAZZZ26241ZMedicare PIN